Provider Demographics
NPI:1871772558
Name:MOUNTAIN ANESTHESIA CONCEPTS PC
Entity type:Organization
Organization Name:MOUNTAIN ANESTHESIA CONCEPTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HOPE
Authorized Official - Middle Name:R
Authorized Official - Last Name:ENGSBERG-RAUZI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:720-273-4596
Mailing Address - Street 1:PO BOX 957
Mailing Address - Street 2:
Mailing Address - City:MORRISON
Mailing Address - State:CO
Mailing Address - Zip Code:80465-0957
Mailing Address - Country:US
Mailing Address - Phone:720-273-4596
Mailing Address - Fax:
Practice Address - Street 1:1666 RACE ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-1112
Practice Address - Country:US
Practice Address - Phone:720-273-4596
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-30
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO31368207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COF33178Medicare UPIN
COC459548Medicare PIN